Provider Demographics
NPI:1164477451
Name:TOTAL CARE PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:TOTAL CARE PHYSICIANS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-798-0666
Mailing Address - Street 1:405 SILVERSIDE RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1774
Mailing Address - Country:US
Mailing Address - Phone:302-798-0666
Mailing Address - Fax:302-798-4905
Practice Address - Street 1:405 SILVERSIDE RD
Practice Address - Street 2:SUITE 111
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-1774
Practice Address - Country:US
Practice Address - Phone:302-798-0666
Practice Address - Fax:302-798-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1989051441207Q00000X, 207Q00000X
DE1998200215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000237702Medicaid
DE0000237702Medicaid